Important Alerts and Reminders
- Aetna Choice POS II has been the wraparound network supplementing the Benefit Funds’ directly contracted network for coverage outside New York City since March 2, 2023. Aetna Choice POS II New York City provider locations are considered nonparticipating. Members must use the Benefit Funds’ provider network when seeking medical services in New York City. If members receive services from Aetna Choice POS II network providers in New York City, Aetna‘s allowance is not applicable, and services are paid at the Benefit Funds’ non-participating schedule of allowances.
- Keep your information up to date. Please review the information we have on record for you, then submit any changes using the Provider Demographic Information Change Request Form, along with a Form W-9. You can easily access the form and instructions from the Benefit Funds’ online provider directory by finding your listing in the directory, selecting “Report an Issue” and indicating your role as provider. While in the online directory, add your photo to your directory profile by selecting “Upload Provider Photo.”
More Provider Connections
Change Healthcare, Inovalon ABILITY Network FAQs
If I do not have access to the Inovalon ABILITY Network, how do I submit claims? Please inform your clearinghouse that the Benefit Funds now use the Inovalon ABILITY Network. Your clearinghouse should be able to establish a connection to route claims there. If I...
Ensure Faster Claims Processing by Using Correct Billing Codes
The National Correct Coding Initiative (NCCI), which promotes national correct coding methodologies and controls improper coding and incorrect payments for medical services, includes three types of edits: NCCI Procedure-to-Procedure Edits prevent inappropriate payment...
ClaimsXTen Select Is Now Lyric
The Benefit Funds’ claims auditing software ClaimsXten Select is now Lyric. Only the name—not the software—has changed. Lyric will continue to assess the appropriateness of professional and outpatient hospital claims against clinically based coding rules and edits,...
The Benefit Funds Credentialing Committee Seeks Board-certified Physicians
The Benefit Funds invite all board-certified participating providers with exemplary credentials and leadership qualities to join the 1199SEIU Benefit Funds Credentialing Committee. As a committee member, you would help ensure that the Benefit Funds maintain a...
The Benefit Funds Are Recredentialing Our Provider Network
The Benefit Funds are recredentialing our provider network and need your help to ensure that members have access to quality in-network healthcare providers. Please update your Council for Affordable Quality Healthcare (CAQH) application and your attestation form. You...